CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Astera Health

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $396
Cash Discount Price: $728
vs. Medicare Baseline: 0.42x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Astera Health is $396. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $728. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.42x the Medicare baseline. Located in 421 11Th Street Nw, Wadena, MN.

Cash / Self-Pay

$728

Average discount available for prompt cash payment at this facility.

Insurance Median

$396

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$950.1

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $950.1 (100%)

Cash / Self-Pay: $728 (77%)

Insurance Median: $396 (42%)

Cash: $728 (77% of Medicare)

Ins. Median: $396 (42% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $950.1 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Ucare Pmap [30006]	$127 - $2,539	13%
Blue Plus Pmap [40002]	$130 - $1,775	14%
Health Partners Pmap [10046]	$130 - $3,508	14%
Medica Pmap [10057]	$130 - $2,601	14%
Primewest Pmap [30003]	$130 - $2,601	14%
UnitedHealthcare	$241 - $5,391	25%
Health Partners [10045]	$292 - $4,986	31%
Medica Nonpmap [10056]	$313 - $78,528	33%
Blue Cross Blue Shield	$323 - $3,550	34%
Primewest Non Pmap [30004]	$323	34%
Ucare Non Pmap [30007]	$323 - $2,929	34%
Sanford Health Plan [10120]	$536 - $692	56%
Ucare Commercial [10705]	$749 - $5,185	79%
Multiplan	$806 - $5,579	85%
Aetna	$907 - $6,277	95%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $728.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 45378.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Astera Health is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 45378.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.